Healthcare is the maintenance or improvement of health in human beings. It includes the work done in providing primary, secondary and tertiary care as well as in public health. According to the World Health Organisation, a well-functioning healthcare system requires a good financing mechanism, well-trained and adequately paid workforce, reliable information on which to base decisions and policies, and well maintained health facilities and logistics. As one can imagine, this is rather challenging to achieve, especially in developing countries. Hospitals, for example, are complex organisations, with highly interconnected and complex planning problems. In addition, governments are striving to reduce the overall cost of healthcare, while both the population of people required healthcare services are increasing. As a result, one of the fundamental challenges in healthcare management is to achieve, with limited funding, an efficient utilisation of expensive resources, while maintaining or increasing the quality of care for an increasing population. Operations research can and have played an important role in answering this question, along with other important healthcare questions. Topics have ranged from clinical areas such as optimal choosing of beams of radiation for intensity modulated radiotherapy treatment in cancer treatment, to simulation of queuing systems, scheduling of doctors and bed management. In our research, we aim to contribute to this growing knowledge base of decision support models to help improve service delivery, lack of access and the cost of healthcare in South Africa.
PROJECT: IMPROVING PATIENT WAITING TIME IN A PRIMARY HEALTHCARE CLINIC
In collaboration with a South African clinic
In South Africa, partly due to a fast increasing population relying on public healthcare services, as well as the recurring treatment of HIV, TB and other chronic diseases at clinics, there is an increasing demand for speciﬁcally primary healthcare services. Limited funding, personnel and infrastructure expansion has led to overcrowded clinics, long waiting times for patients before consultation, and extended staff working hours in primary healthcare clinics in South Africa. In addition, the appointment and queuing system at some clinics in South Africa seems to be inefficient, as patients sometimes wait from 8am in the mornings until the afternoon, even though their appointment may be at 10am.
In this project, the workﬂow, appointment and queuing system of a clinic in the winelands region of South Africa will be investigated. Using techniques such as queuing theory and discrete event simulation, new strategies will be recommended that could reduce the average waiting time per patient before consultation without compromising on quality care.
Members involved: Annelie Wessels, Linke Potgieter
PROJECT: DOCTOR SCHEDULING IN AN EMERGENCY CENTRE
In collaboration with a South African public emergency centre
Due to the limited budgetary allocation by the South Africa government, public health care facilities are under constant pressure to satisfy the demand for health care services and are severely under staffed relative to the demand requirement. The primary objective in this project was the construction of fair ergonomic shift schedules for doctors that satisfy the demand, take individual preferences into account and reduce the health risk associated with overworked personnel. An important lesson learned from this project is that given the budgetary constraints and resulting staff shortages, it is impossible to create a fair ergonomic schedule for doctors working in the case study public health care emergency centre that adheres to the Basic Conditions of Employment Act.
Members and alumni involved: Candice Muller, Linke Potgieter